Patients with anomalous connection of the left coronary artery to the pulmonary artery are at risk for myocardial infarction, and early or sudden death. Between 1986 to 1992, a total of 4 of these patients underwent surgical intervention with various operative techniques at our institution. Age at operation ranged from 2 months to 43 years. Three infant patients had congestive heart failure, 2 of them had mitral regurgitaion, and 1 had ST-T change on elctrocardiogram. Operative techniques included direct coronary artery transfer to the aorta[n=2], intrapulmonary tunnel from the aortopulmonary window[n=1], coronary artery bypass using saphenous vein[n=1]. One deaths occured at 2 weeks after direct coronary arterial transfer due to respiratory failure caused by Respiratory Syncitial virus pneumonia. Supravalvar pulmoanry stenosis occured after intrapulmoanry tunnel. We recommend direct aortic implatation of the anomalous coronary artery at the time of diagnosis. Intrapulmonary tunnel from aortopulmonary window or subclavian-coronary anastomosis could be alternatives in whom aortic implantation is not feasible anatomically.